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  • David Crosby died this month at age 81.
  • His cause of death has not yet been made public.
  • Crosby had a number of health issues in his lifetime including needing a liver transplant in 1994.

Rock musician David Crosby — singer with the Byrds and with Crosby, Stills and Nash — died this month at 81.

The singer’s cause of death has not been revealed, but he had faced health challenges in the decades prior.

In 1994 Crosby underwent a liver transplant, and experts say the long-term success of his transplant is a sign of the medical advancements in treatment.

The first successful liver transplant happened in the 60s, shortly before Crosby formed the long-running band with Stills and Nash.

In general, “we think that life expectancy [after liver transplant] now far exceeds 20 years for the average person, which is really remarkable,” Dr. Brian P. Lee, a hepatologist and transplant specialist with Keck Medicine of USC in Los Angeles, told Healthline.

Crosby was able to live for almost three decades after his transplant in 1994. Experts say that is increasingly becoming more common and the survival rate is high, especially in the first five years after a transplant.

According to a 2016 report, fewer than 10% of liver transplants fail during the first year. The five-year survival rate for liver transplant recipients was almost 75%.

An earlier study found that the 18-year survival rate was 48%.

Dr. Malay Shah, surgical director of the liver transplant program at UK HealthCare in Lexington, Kentucky, told Healthline that once recipients of a liver transplant get past one year, they tend to do well long-term.

“If this surgery didn’t provide you with a good chance of living a long time, then nobody would be doing liver transplants for a living,” he said.

Lee said recipients’ longer life expectancy is due, in part, to improved surgical technique, a better understanding of immunosuppression and tissue rejection, and the ability to manage the complications that occur after transplant.

Shah said selecting patients that are well-suited for a transplant can also help improve outcomes.

“We obviously look at…their cardiovascular status — their heart and lungs — to make sure that they’re healthy enough to undergo a liver transplant,” he said.

In addition, he said transplant surgeons will assess other factors. For example, are patients going to take anti-rejection medications regularly after transplant, are they going to come back to the clinic for check-ups, etc.?

“We also look at whether or not the patient has a good social support system to help them after their transplant,” he said.

In spite of the improved long-term survival for many people after liver transplant, “there’s still a long way to go,” said Lee, “because some people do better than others.”

In a study published in the American Journal of Transplantation, Lee and his colleagues examined data for all liver transplant recipients in the United States between 2002 and 2018.

They found that, on average, Black patients had a 15% higher chance of dying after a liver transplant than white patients. And in 2017 and 2018, Black patients had a 60% higher risk of dying than white patients.

“Historically, Black people have not done as well as other races [after liver transplant],” said Lee. “But what was concerning about the study was that we found that not only are they doing worse [than whites], but that the gap has actually widened in recent years.”

The survival gap between Black patients and white patients also increased with the number of years after transplant, they found.

Lee and his colleagues identified two factors that partially contributed to this survival gap. The first was alcohol-associated liver disease — damage to the liver caused by heavy consumption of alcohol.

“We know that in the general population, the rates of heavy drinking have been rising faster among [Black people] than whites,” he said.

The second factor was which type of health insurance patients had.

Black transplant recipients were more likely than white recipients to be insured through Medicaid, and less likely to have private insurance.

This may impact the type of care, including preventative care, they are able to receive.

The greatest risk after a liver transplant is transplant failure, in which the body rejects the new liver. This risk can be reduced through the use of anti-rejection medications, or immunosuppressants.

People who receive a liver transplant have to take these medicines for the rest of their life to help the liver survive in the body. Long-term use of these medicines can have certain side effects.

“Because transplant recipients are on anti-rejection medications, which weakens the immune system’s response, they have a higher risk of developing an infection,” said Shah.

These medications can also increase the risk of certain types of cancer.

Other complications of liver transplant include bleeding, damage to the bile ducts and blood clots.

While people who receive a liver transplant will need to have regular checkups with their doctor to monitor for complications, a successful transplant can improve a person’s quality of life.

“People are living long and fulfilling lives after a transplant,” said Lee. However, “there’s still such a long way to go — there are people being left behind, even after they received transplant.”